104例肾嫌色细胞癌的临床分析  

Clinical analysis of 104 cases of chromophobe renal cell carcinoma

作　　者：王养才 李思洁 罗兴 陈伟 WANG Yangcai;LI Sijie;LUO Xing;CHEN Wei(Department of Urology,Second Affiliated Hospital,Army Medical Univer-sity,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院泌尿外科中心,重庆400037 [2]陆军军医大学第二附属医院儿科,重庆400037

出　　处：《现代泌尿生殖肿瘤杂志》2024年第1期10-14,20,共6页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：国家自然科学基金面上项目(81970590)。

摘　　要：目的探讨肾嫌色细胞癌的临床特点、治疗方式的选择及患者预后生存情况。方法回顾性分析陆军军医大学第二附属医院2012年1月至2022年1月收治的104例经术后病理诊断为肾嫌色细胞癌(chRCC)的患者临床资料。所有患者均行手术治疗,对患者的影像学资料、病理资料及术后生存情况进行分析和总结。结果104例患者中有67例行CT检查,报告显示平扫期多数呈等密度或稍高密度软组织影,肿瘤内若存在坏死灶,则可能出现混杂密度影,部分肿瘤内有钙化,增强期大多呈现轻度或中度不均匀强化;4例行MRI检查,强化时均呈不均匀强化,静脉期强化均减退;病理结果示chRCC主要包括两种细胞类型,一种为体积较大的多角形半透明细胞,另一种为小圆形的嗜酸性细胞。8例患者失访,3例患者因非肾肿瘤性疾病死亡,2例因转移死亡,其余患者均长期生存,预后良好。结论chRCC临床症状不典型,超声可作为首选体检筛查手段,CT和MRI检查在chRCC诊断上也具有一定优势。手术为早期chRCC首选治疗方案,多数患者预后良好,极少数患者术后出现转移或复发。晚期chRCC目前尚无统一治疗方案。Objective To analyze and summarize the clinical pathogenesis characteristics,treatment and survival of chromophobe renal cell carcinoma(chRCC).Methods From January 2012 to January 2022,the clinical data and postoperative follow-up data of 104 patients with postoperative pathological diagnosis of chRCC in our hospital were retrospectively analyzed,and the patients'medical history characteristics,imaging data,pathological data and postoperative survival were analyzed and summarized.Results CT reports were available in 67 cases,and most of them showed isodensity or slightly high-density soft tissue shadow in the plain phase.If there were necrotic foci in the tumor,there might be mixed density shadow.Some of them had calcification in the tumor,and most of them showed mild or moderate inhomogeneous enhancement in the enhancement phase.Four cases underwent MRI examination.All of them showed inhomogeneous enhancement in the enhancement,and all of them had hypoenhancement in the venous phase.There were two main cell types in the pathological findings,large polygonal translucent cells and small round eosinophils.All patients were treated surgically.Eight patients were absent from follow-up.Three cases died of non-renal neoplastic diseases,and two cases died of metastatic disease,.The rest of the patients survived for a long time.Conclusions The clinical symptoms of chRCC are atypical.Most of them are found by physical examination,so ultrasound can be used as the preferred physical examination screening method.CT and MRI have certain advantages in the diagnosis of chRCC.Surgery is the preferred treatment for early chRCC.Most patients have a good prognosis,but a very small number of patients still have metastasis or recurrence after surgery.However,there is no effective treatment for advanced chRCC.

关 键 词：肾细胞癌 肾嫌色细胞癌 影像学检查 临床分析 

分 类 号：R73[医药卫生—肿瘤]